[wpasc]

Ankylosing Spondylitis patient here who has tried and failed most NSAIDS, Sulfasalazine, and 3 TNF inhibitors. Don't feel dread towards this notion! The immune system is definitely super complex and spaghetti code like, but rheumatology and science in general is working it's way through reverse engineering it. Since TNF inhibitors have come out, lots of data on these monoclonal antibody drugs that inhibit specific parts of the immune system have been gathered. The short term and long term side effects are noted and increasingly understood. If your rheumatologist has a good bedside manner, they should give you some comfort in how widely many of these drugs are used, what is known, and what is unknown.

I'm not trying to make any claims that we are close to a full or maybe not even good understanding of how the immune system works, but science is definitely advancing towards reducing the unknowns. I've been through the ringer of all the treatments and currently am not able to find relief in any, but I'm just trying to offer some hopeful empathy as someone who has at times felt dread from having very rare side effects to a whole bunch of the medicines and I rarely feel dread in general despite the uncertainty and my pain.

As always, talk things through with your rheumatologist and GP if you have concerns.